As is well known ophthalmic devices such as OCT scanners generate large volumes of proprietary data that cannot be displayed on the web and require installation of expensive custom software on a computer in order to review the results of an exam and also to be able to exercise the OCT device to provide various segmentations or views of the data.
It is true that device manufacturers provide software to review or manipulate exam data, however, at significant cost and only operating on a local area network.
This is neither convenient nor helpful to most ophthalmologists who see patients in multiple exam rooms, in more than one office and in many cases see the same patients in multiple offices. Moreover, ophthalmologists have a need to consult with referring physicians to review patient exam data. Thus the need exists for a system that can extract raw data from ophthalmic OCT devices, upload the data to a server and provide the user with the ability to review and manipulate the exam data from any web-enabled computer with the same functionality and control as the ophthalmic device itself.
More particularly, optical coherence tomography devices are computer driven so that one can operate their software to view and quantify exam data so that an individual practitioner can do an analysis of the images on the device itself. One can measure retinal thickness and change over time and do so on three dimensional diametric scans that are remotely viewed on computers connected to the same local area network so that a person who is not in the examining room is able to do various types of analysis on the exams.
In order to accomplish such a goal, manufacturers have developed remote viewing software packages that need to be installed on each computer in order to run and have to be connected to a local area network, meaning the network that exists in the same office. Moreover, such a network is often times very crowded or segmented and no attempts are made to optimize speed or connection quality between the OCT device and the viewing computer. After software has been installed and each computer has been configured properly to communicate with the OCT device, a practitioner can go to the next exam room in the same office and pull up the exam data to view it.
Some systems are currently attempting to provide wide area network WAN access to ophthalmic OCT exams. However they are primitive in nature and are “image only” displays which are lower quality and limited representations of the raw data, and in many cases are simply scanned copies of printed paper reports. They import standard image file formats such as TIF, BMP, JPG and AVI; and they display them in a web page, which is highly inefficient and occupies far more storage space than necessary. However, OCT exams contain much more data than simple images and this limits the user's ability to manipulate or analyze the exam.
As mentioned before, many manufacturers require custom software installation on each computer in order for the user to be able to use and view the images. The problem with this type of approach is that one has to have a separate piece of software for each device, and for each manufacturer; and if one wants to view them simultaneously there is no common platform available. More particularly, there is no convenient way to review a patient exam record that incorporates exams performed on two different devices.
While recent attempts have been made to create some remote viewing functionality, these fail if a doctor has one office A and then across town there is an office B. This is because both offices are not on the same local network and one would need some sort of web-enabled remote viewing package such as Logmein or TightVNC.
The problem with remote viewing packages such as TightVNC, Logmein, and other remote viewing packages is that they provide very limited functionality and display of the data. Moreover, there are certain bottlenecks to the use of standard web-enabled viewers.
If one is simply interested in remote viewing and control via virtual control of a computer, if for instance a doctor is in Office A and wants to see an exam in Office B, he would have to make sure that no one else is using the device in Office B or else he would have to wait until the user finishes. Thus one of the problems remote viewing is multiple users.
The second problem with web-enabled remote viewers is the low quality of the images on the screen. The reason for this is that present remote viewing packages usable on the web use compression to speed up the transmission of the data in order to be able to see the changes on the screen. However, these compression techniques operate in color space due to the high color depth of graphics displays, and present a noticeable reduction in the quality of the transmitted images.
Finally, there is the question of latency. Remote viewing web-enabled programs to date repaint or refresh the screen when there is a change in any part of the data being displayed. Thus latency is very high when one is refreshing the screen and drawing images. This means that the practitioner has to wait for the screen to refresh, sometimes on the order of many seconds. As will be appreciated, the more one changes the screen the more data that has to be transmitted and therefore the slower the response of the program.
It will also be appreciated that not only is remote viewing desirable, remote manipulation of the data is also required. For instance as one wants to pick a particular segmentation, zoom in on some particular data, change a particular parameter in the basic program or in general remotely access the original device, currently there is no way in order to provide such a service.
In short, and as mentioned above, the current systems that are attempting to provide wide area network access to ophthalmic exams are either primitive, low resolution image only displays having little or no ability to manipulate and analyze an exam, or have high latency, poor image quality and introduce bottlenecks into clinic flow. As mentioned, existing systems require custom software installation on each computer, and those systems that utilize remote viewing and applications are problematic due to the lag time of transmitting the desktop images over the web. Moreover, the images that are produced are of poor quality due to compression. These systems also create a bottleneck because the user cannot review an exam while the device is in use by someone else.